title: Increases in behavioral health screening in pediatric care for Massachusetts Medicaid patients.
abstract: OBJECTIVE
  To explore rates of screening and identification and treatment for behavioral problems using billing data from Massachusetts Medicaid immediately following the start of the state's new court-ordered screening and intervention program.
  
  
  METHODS
  Retrospective review of the number of pediatric well-child visits, number of screens, and number of screens that identify risk for psychosocial problems from January 2008 (the month pediatric screening started) to March 2009. During the surrounding 1-year period, we also examined the number of claims with a behavioral health evaluation code.
  
  
  METHODS
  Massachusetts.
  
  
  METHODS
  Massachusetts Medicaid-enrolled children.
  
  
  METHODS
  Funded court-ordered mandate to screen for mental health during Medicaid well-child visits.
  
  
  METHODS
  Percentage of visits with a screen, percentage of screens identified at risk, and number of children seen for behavioral health evaluations.
  
  
  RESULTS
  Major increase from 16.6% of all Medicaid well-child visits coded for behavioral screens in the first quarter of 2008 to 53.6% in the first quarter of 2009. Additionally, the children identified as at risk increased substantially from about 1600 in the first quarter of 2008 to nearly 5000 in quarter 1 of 2009. The children with mental health evaluations increased from an average of 4543 to 5715 per month over a 1-year period.
  
  
  CONCLUSIONS
  The data suggest payment and a supported mandate for use of a formal screening tool can substantially increase the identification of children at behavioral health risk. Findings suggest that increased screening may have the desired effect of increasing referrals for mental health services.
authors.affiliation: Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, MA 02114, USA. kkuhlthau@partners.org
authors.forename: Karen
authors.initials: K
authors.lastname: Kuhlthau
authors.forename: Michael
authors.initials: M
authors.lastname: Jellinek
authors.forename: Gwyne
authors.initials: G
authors.lastname: White
authors.forename: Jeanne
authors.initials: J
authors.lastname: Vancleave
authors.forename: Jack
authors.initials: J
authors.lastname: Simons
authors.forename: Michael
authors.initials: M
authors.lastname: Murphy
mesh_terms: D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008404:Massachusetts / Q000453:epidemiology; D008484:Medicaid / Q000706:statistics & numerical data; D011320:Primary Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology